CASE 362: ACUTE FEMALE PELVIS PAIN, Dr PHAN THANH HẢI, MEDIC MEDICAL CENTER.

Women 21 yo, single, acute  hypogastric pain, polykiuria, normal urine analysis.Ultrasound  scanning in pelvis  shows uterus  normal in size with endometrium thickening, fluid  arround  uterus looks like  blood (US 1)  and  on right  site of uterus existing one round mass, size  of 5 cm  with multiple cystic (US 2), US 3=  Color Doppler this mass is normal vascular , US 4=  PW Doppler of  right uterine artery  with RI =0.82.Sonologist  alerts bleeding intrapelvis and suspecting of  rupture of right  ovary cyst.

MSCT with CE : Non intrauterus pregnancy (CT1), this mass  at right parameter is cystic in central part and thickening wall with  blood  arrounding.  Radiologist diagnosis is hemoperitoneum due to rupture of corpus luteinic at the  right ovary, blood volume  arround 100ml.

Blood test  makes sure  negative beta HCG.Clinical finding  is acute pelvis pain in single female patient, ultrasound quickly detected bleeding  intrapelvis,  and blood test rule out ectopic pregnancy.

Ultrasound is best diagnosis and follow up this case  no need  CT.This patient was admitted  obgy hospital for  survey in  3 days and discharged laterConclusion:   in female patient, of acute  pelvis pain  ultrasound is first choice of imaging modalities  for  diagnosis about  corpus luteinic  rupture bleeding, and  beta HCG confirms for diagnosis of  MITTELSCHMERZT  SYNDROME.